Τίτλος:
Increased kinetic growth rate during late phase liver regeneration
impacts the risk of tumor recurrence after colorectal liver metastases
resection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Although experimental data strongly support the
pro-tumorigenic role of postoperative liver regeneration, this
hypothesis has not been clinically investigated. We aimed to examine the
impact of liver regeneration determined by volumetric imaging on
recurrence following resection of colorectal liver metastasis (CRLM).
Methods: Resected liver volume was subtracted from total liver volume
(TLV) to define postoperative remnant liver volume (RLVp). Early and
late kinetic growth rates (KGR) were defined as the postoperative
increases in liver volume within 2-3 and 8-10 months from surgery,
respectively, divided by the corresponding time interval.
Results: Median early and late KGR was 2.6%/month (IQR: -0.9 to 12.3)
and 1.0%/month (IQR: -0.64 to 2.91), respectively. Late KGR predicted
intrahepatic recurrence after 1 year from surgery (AUC 0.677, P =
0.011). Specifically, patients with a late KGR >= 1% had a higher
cumulative risk of recurrence compared with patients with a KGR < 1% (P
= 0.038). In multivariate analysis, KGR >= 1% independently predicted
recurrence (P = 0.027).
Discussion: A KGR >= 1% during the late regeneration phase was
associated with increased risk of intrahepatic recurrence. These data
may inform the timing of adjuvant therapy administration and focus
surveillance strategies for high-risk patients.
Συγγραφείς:
Margonis, Georgios A.
Sasaki, Kazunari
Andreatos, Nikolaos and
Pour, Manijeh Zargham
Shao, Nannan
Ghasebeh, Mounes Aliyari and
Buettner, Stefan
Antoniou, Efstathios
Wolfgang, Christopher L.
and Weiss, Matthew
Kamel, Ihab R.
Pawlik, Timothy M.
Εκδότης:
Elsevier Sci Ltd, Exeter, United Kingdom
DOI:
10.1016/j.hpb.2017.05.002
